Lead/Presenter: Jodie Katon, COIN - Seattle/Denver
All Authors: Katon JG (VA Puget Sound HSR&D COIN for Veteran-Centered and Value-Driven Care), Zephyrin, L (VA Harbor Medical Center), Yano, E (VA Greater Los Angeles HSR&D COIN for the Study of Healthcare Innovation, Implementation and Policy; UCLA School of Public Health) Patton, E (VA Boston Healthcare System; Boston University School of Medicine)
Objectives:
To leverage a national work group to conduct a systematic review of the growing literature on women Veterans' reproductive health, and disseminate findings to VA leadership and other stakeholders to inform policy and programming decisions.
Methods:
Standard search terms were used in PubMed and CINAHL to identify manuscripts published between 2008 and July 1, 2017. All manuscripts were reviewed by two researchers from the work group using standardized inclusion criteria and an abstraction form developed with input from the group. Disagreements were adjudicated by the first or senior author.
Results:
Forty-eight percent of the 52 included manuscripts addressed contraception and preconception care (n = 15) or pregnancy (n = 10). Findings suggest that 1) contraceptive use and rates of unintended pregnancy among women Veterans using VA healthcare are similar to the general population; 2) demand for VA maternity care is increasing; and 3) women Veterans using VA maternity care are a high-risk population. Significant gaps in research remain with respect to STIs, infertility, and menopause. Sexual assault and mental health conditions were highly prevalent among women Veterans and associated with a wide variety of adverse reproductive health outcomes across the life course.
Implications:
The literature on women Veterans' reproductive health is rapidly expanding. Knowledge gaps persist in the areas of STIs, infertility, and menopause. Findings support continued VA quality improvement for contraceptive and maternity care, prevention of and support for survivors of sexual assault in the military and VA, and integration of reproductive health and mental health care.
Impacts:
National networks and work groups can effectively promote and summarize research to inform quality improvement efforts for minority patient populations. Working in partnership with VA policymakers these groups are critical for communicating key research findings and impacts to a range of stakeholders. Partnerships also ensure that research aligns with legislative and policy agendas and is designed to inform and support implementation of programs. Communication strategies that deliver information in an easily digestible and actionable way are needed to legislative and policy stakeholders to support meaningful improvements. To address this need fact sheets and visual abstracts based on the findings are being developed.